Last year was not a great year for me, health-wise. I got shingles, pneumonia, and the flu. I had to get an endoscopy because of stress-related indigestion. I twisted my knee while snowboarding and couldn’t run for a month.
Also, I got my first STI. And then I got my second.
For the uninitiated, STI stands for “sexually transmitted infection.” Most of us grew up calling them STDs. Most of us were also instilled with a deep fear of them – and not much else. We were taught that people who got STIs are morally decrepit, physically loathsome, and doomed to die, but we weren’t taught about how they are treated, how to talk to our partners about them, or how to test for them responsibly.
So when I got scabies, the first thought that ran through my head was, “This is the worst thing that has ever happened,” and the second was, “My partners are going to hate me.”
From what I’ve seen, that’s a pretty common reaction, but it doesn’t need to be. Here’s what I wish I had known:
1. Most STIs are easy to treat or manage (if you catch them early).
Chlamydia is treated with a pill. Gonorrhea is treated with a shot in the arm. HIV is managed with a few pills per day. Syphillis is treated with a shot in butt. Scabies (which isn’t technically an STI) is treated with a cream. And if you have health insurance, most of these treatments don’t cost that much, either.
2. You can’t test for STIs the day after you’ve had sex.
Most STIs take at least a couple of weeks to show up in your blood, urine, or saliva, so there’s no point in getting tested right after you’ve had sex. The period of time between when you’re infected and when the infection shows up on tests is called the testing window. Testing windows can be as long as three months, which means…
3. Getting an STI while in a monogamous relationship does NOT mean your partner has cheated on you.
Not only do testing windows make it complicated to figure out exactly where and when you contracted an STI, but many STIs are asymptomatic (i.e. invisible), at least at first. This means that you or your partner could contract chlamydia, gonorrhea, syphilis, HIV, HPV, or herpes and simply not know. Since many people don’t go in for testing unless they’re showing signs of infection, it’s pretty common for people to bring STIs into monogamous relationships without even realizing it.
4. Most sexual health clinics will not test for herpes unless you have a visible outbreak.
This is because testing for herpes is a waste of resources: there’s no treatment and it’s not very contagious except during outbreaks (when sores appear around the genitals). The most you can do for herpes is take an anti-viral to keep outbreaks (which can happen up to five times per year but rarely occur that frequently) in check and avoid sex when you have sores.
5. HIV can stay invisible for up to ten years (so test regularly).
There’s a lot of misinformation out there about HIV. While it’s indeed a scary disease, people who find it early can live completely normal, healthy, long lives with the aid of modern anti-retroviral drugs. Unfortunately, a lot of people don’t get tested for HIV regularly because they don’t know that it can stay invisible for up to a decade. For people who are regularly having penetrative sex (especially with multiple partners), I recommend getting tested every four to six months.
6. If you’re worried about HIV, you can always go on PrEP (Truvada).
Truvada (sometimes referred to as PrEP, or “pre-exposure prophylaxis”) is a pill that is extremely effective at preventing HIV transmission. In order for it to be effective, you must take it once per day while you’re sexually active. If you’re interested in Truvada, talk to your doctor about getting a prescription. Truvada can be pretty expensive, but if you think it’s the right choice for you, take a look at the Truvada Financial Assistance Program.
7. You and your partner(s) should all get treated at the same time, even if one isn’t displaying symptoms.
Again, testing windows and asymptomatic STIs can make it very hard to figure out who’s been infected and when. Even if only one of you is displaying symptoms, it’s important for all of your partners to get treated at the same time as you. Otherwise, you could bounce the infection back and forth between you, potentially causing antibiotic resistance. It’s much harder and more painful to stop STIs once they’ve become resistant to conventional treatments.
8. You can’t diagnose yourself.
I don’t care how many pictures of chlamydia you’ve seen on the internet; there’s no way to tell what’s going on inside of your body until you talk to a medical professional. The longer you wait to speak to someone, the higher your risk of developing painful symptoms and/or spreading the infection to people you care about.
All primary care doctors, urgent care doctors, and sexual health clinics will be able to talk you through the process of testing and treating whatever’s happening down under.
9. If your partner freaks out, they either don’t understand STIs or shouldn’t be having sex.
It’s normal for you or your partners to feel upset after testing positive for an STI, especially a chronic one such as HIV. However, there’s no reason to grow angry or suspicious towards the people you love. Now is when you need them most! If your partners lash out at you, demean you, or otherwise hurt you for talking to them about sexual health, you might want to consider finding a new partner.
I understand how scary it can be to tell your partners that you have an STI. At the same time, it’s a great opportunity to figure out exactly who you’ve been sleeping with. Is their first instinct to care for you? Are they able to maintain a sense of calm? Are they willing to get tested and, if necessary, treated? You might be surprised by how wonderfully, amazingly good they can be.
I know I was.